Two-hundred and fifty people gathered on the steps of the Colorado Capitol Saturday, May 30 as part of a "National Day of Action" to advocate for a single-payer model of health care reform. People came from Colorado Springs, Buena Vista and Ft. Collins as well as metro Denver to share stories and data about the utter failure of U.S. health care, which has become a profit-center for multi-payer insurances and hospitals at the expense of health care access for the people of Colorado.

Roya, a rally organizer from Health Care for All Colorado, related the story of a friend, repeatedly denied health care due to a "pre-existing" condition of cancer, until she died. Mike, a leader of ArapaHope Community Team, another rally organizer, told of continuous denial of health care coverage since he had a mild heart attack 14 years ago.

Fort Collins physician, Dr. Cory Carroll expressed the frustration of primary care providers whose care for patients is often complicated or obstructed by for-profit private insurances that assume the right to deny or delay claims.

Sen. Morgan Carroll observed that insurance companies make their profit by over-charging premiums, which rose 98% from 2000-2007, and by denying necessary health care. In Colorado, unlicensed and unqualified insurance industry folks deny necessary medical treatment. Asking "Where are our priorities?" Sen. Carroll noted that we have spent billions more on wall street bailouts than it would cost to provide health care to every single American for decades. Read more of Sen. Carroll's remarks.

Single-Payer has been declared "off the table" by Sen. Baucus and others in Washington. When Gov. Howard Dean visited Denver last week to promote a parallel public health care option, he drew gasps from his progressive audience when he suggested that Medicare Part D was "good" reform --perhaps a mark of the insularity of Washington culture, and a disconnect  on the part of some of our leaders.

Rep. John Kefalas has done a stellar job of shepherding the Colorado Guaranteed Health Care Act (HB 1273) through two committees - Business Affairs & Labor and Appropriations - and a second reading in the House. The bill is scheduled for 3rd reading and final vote in the House on Monday, April 13, where it now has 32 votes. One more vote is needed or it will die.

Six Democrats have yet to indicate they will vote affirmatively.

Please call and email each of the following representatives before 9 a.m. on Monday morning.

Speaker Terrence Carroll 303-866-2909 terrance.carroll.house@state.co.us

Rep. Kathleen Curry 303-866-2945 kathleencurry@montrose.net

Rep. Wesley McKinley 303-866-2398 mckinley@cowboywes.com

Rep. Karen Middleton 303-866-3911 karen@karenmiddleton.com

Rep. Jim Riesberg 303-866-2929 jim.riesberg.house@state.co.us

Rep. Christine Scanlan 303-866-2952 christine.scanlan.house@state.co.us


The Board of Directors of the Health District of Northern Larimer County wrote a 6-page objective analysis of HB 1273, and voted unaminously to endorse the bill - one of more than 60 group endorsers. Read their Analysis.

The Northern Colorado Business Report, which has remained out in front in reporting on health care reform, on March 13 printed an editorial endorsement of HB 1273. Read their Endorsement.

Opponents of HB 1273 have predictably focused on "free market" arguments invoking "competition" and "choice", though, honestly, people want a choice of health care providers, not minimum-benefit insurances that leave them at risk. Rep. Kefalas has consistently maintained that to move to a quality-centered health care system, competition should occur among providers, not among for-profit insurances. Kefalas rightly notes that we need a new health care paradigm that also permits greater transparency in order to facilitate determination of best practices and health care outcomes. Currently, thousands of different insurers each maintain secrecy around their own proprietary data.

One of the oft-used arguments to foreclose debate of HB 1273 - used by Republicans and by the governor’s office - has been the notion that the 208 Commission studied the single payer proposal in depth and rejected it. Nevertheless, we who were present at most of the 208 Commission meetings witnessed the almost immediate dismissal of any consideration of the Single Payer model. There was true disbelief expressed by Commission Chair Bill Lindsay (among others) - "That can’t be!" - when the Lewin Group reported the cost savings of single payer. It was the only one of 5 proposals that showed cost savings for providers, businesses, families, hospitals, and a net savings for the state of $1.4 billion, as well as the ability to provide comprehensive coverage for all.

There was never any attempt by the Commission to follow up with study of  the Single Payer model - rather, they dismissed it in 4 cursory sentences in their Final Report to the legislature, calling it "politically unfeasible." The Commission devoted most of their time to writing their own proposal of incremental reforms based on the Massachusetts model of a mandate for private insurances.

So, debate around the Single Payer model has been consistently short-circuited at all levels, with an effective media blackout among the large Denver-area print media. It bears repeating that throughout the 208 Commission process, the Denver Post and The Rocky Mountain News rejected pieces related to the Single Payer model, preferring instead pieces by "free-market" advocates. The business editor of the News informed me that he did not want "to confuse his readers" with information about single payer. By comparision, the Ft. Collins and Pueblo newspapers excelled at presenting pros and cons of all aspects of the health care reform debate.

We have yet to have a thorough honest debate of the Single Payer model of health care that has not been distorted by opponents’ framing, too often with capitulation from some of our Democratic leaders. As recently as April 7 when Rep. Diana DeGette gave her signature health care reform speech before the City Club of Denver, she conceded the issue by using opponents’ framing of health care reform. Promising "strong doctor-patient relationships - free from government interference...," DeGette disregarded the fact that only a single-payer model offers full choice of providers; nor did she mention the $20 billion annual interference of private insurance plans that daily breach patient-doctor relationships, gaming the system using "Denial Management" to deny, delay and renege on insurance claims. "...let there be no doubt: ‘socialized medicine’ is not coming to America," promised DeGette. Again, our Democratic leaders too often fail to define issues and inform people, but rather fall into the trap of letting Republicans and corporate interests define the terms of every debate.

For the first time since Rep. Kefalas introduced the Colorado Guaranteed Health Care Act (HB 1273) this legislative session, on Monday April 6 there was a relatively brief (1-1/2 hour) window for debate about the issue of single payer on the House floor. It was a powerful experience to witness  Democrats stepping up to present the case for a sytemic health care reform, countering the specious arguments presented by the opposition. I will summarize the April 6 HB 1273 House floor debate in a subsequent post.

A May 2005 Pew Poll revealed that 65 percent agreed government should guarantee health coverage for every American "even if it means raising taxes." In a 2009 Lake Research Partners survey, nearly 7 in 10 voters expressed a desire for complete overhaul or major reform of the health care system. The April 2008 Annals of Internal Medicine reported that 59 percent of U.S. doctors supported "government legislation to establish national health insurance," an increase of 10 percent of doctors over 5 years.

The debate continues to be short-circuited, an effective blackout in some media markets since the convening of the Colorado 208 Commission on Health Care Reform. Though the CHS single-payer proposal was the only 1 of 5 proposals demonstrating state cost savings of $1.4 billion and comprehensive coverage for all, it was buried in the Commission’s final report and dismissed as ‘politically unfeasible.’

Throughout the 208 Commission process, the Denver Post and The Rocky Mountain News printed only health care reform pieces by ‘free-market’ advocates. The News business editor, Rob Reuteman backed out of his promise to give equal time to single-payer, saying that it is "pie-in-the-sky" and "I don’t want to confuse the readers." Media marginalization continues.

The Colorado Guaranteed Health Care Act (HB 1273) moved out of the Business Affairs Committee on March 18, with at least 100 supporters, many providers and small business owners testifying about the need to address the declining primary care infrastructure and the rising cost that make coverage prohibitive. It was noted that Massachusetts reform is a trainwreck, marked by taxpayer-subsidized private insurance and growing numbers on Medicaid rolls, doubliing Massachusetts health spending, from $630 million in 2007 to an estimated $1.3 billion in 2009.

HCPF director and the governor’s spokesperson, Joan Henneberry spoke against HB 1273, calling it a "a new bureaucracy." In fact, the bill intends to address the unsustainable private and public health care bureaucracies. Multi-payer insurances are paper-intensive with high overhead costs; and the Colorado Medicaid bureaucracy maintains about 20 different categories of Medicaid, each with different means testing and annual reauthorizations that erect barriers to health care access and exponentially increase administrative costs.

On March 27 Colorado State of Mind (ch 6) invited panelists to speak about Colorado health care reform, but failed to include anyone who could speak to the specious arguments raised against HB 1273. Pediatrician Larry Wolk asserted that single payer denies ‘choice,’ and that it represents ‘one-size-fits-all’ -- variations on the ‘free-market’ theme holding that people want a choice of insurances, rather than a choice of health care providers. A choice of minimum-benefit and catastrophic coverage is no choice at all - something employees are discovering as costs rise and more are moved into reduced-benefit policies with high out-of-pocket costs.

Pediatric cardiologist Dr. Reginald Washington noted that even if more people have public or private insurance, there are not enough primary care providers in Colorado to care for everybody. In fact, more primary care providers are leaving private practice, overwhelmed by the burden of dealing with multi-payer networks, copious paperwork, preauthorizations and claims denials that take away valuable time from patients, and require them to hire extra staff.

The Colorado Guaranteed Health Care Act (HB1273) provides the structure for a long-term, systemic solution – simplified billing, quality-centered health care, and full choice of providers and hospitals. It addresses our degraded primary care system with investment in education to address provider shortages; and requires transparency for determining best practices, and incentives for improved health outcomes and costs containment.

The bill passed out of Appropriatiions April 3 and will probably be heard in the full House the week of April 6. All of our legislators and the governor need to hear that there is grassroots support for HB1273. Appropriations members are below. Identify your legislators at www.vote-smart.org . Write an email to the governor at http://www.chcpf.state.co.us/governor/contact.html.

To those who ask why we do this at the state level, there have been federal bills (which may be re-introduced this session) to fund state pilot projects for health care reform. At least one of our congressional delegation is willing to help us at the federal level, and we need to be ready. If you think comprehensive health care reform will happen quickly at the federal level, please read the following piece I wrote for Huffington Post:  Dems & Repubs on Health Care: 'Love a Lobbyist' - we need to urge our federal senators and representatives to work for meaningful reform.

There are national Petitions in process to ask Obama to appoint a Special Prosecutor to lead US Department Of Justice enforcement actions against the Bush appointee Lawyers that advocated felony violations of our Federal Laws on Torture, and Bush, Cheney, Rumsfeld, Who have addmitted Ordering felony

This website is a quick way to sign the Petition to have them Indicted and to ask Obama to appoint a Special Prosecutor Thanks for your assistance.

This latest posting in the "Lamborn Files" comes via the esteemed Colorado Independent (see the Extended Post Text).  Where we learn that the lesser Congressman from Colorado Springs has pronounced his policy for providing Veterans Administration (VA) benefits only to deserving (according to his confused definition) veterans suffering from Post Traumatic Stress Disorder (PTSD) and standing against his delusional tide of undeserving vets suffering from PTSD.

Wendy Norris lays it out pretty clean and to the point reporting this story.  But, there's the rest of the story to consider.  Lamborn's conduct is an indictment both of his inadequacy to represent the people of the heavily military 5th CD, but also of his Party's penchant to picking, choosing (discriminating) and ultimately denying the right of Americans to adequate healthcare.

Perhaps in earlier decades a Congressman could get away with making such statements.  In the age of C-SPAN such an allowance and forgiveness for being horrifically wrong cannot go unanswered and without penalty.  While it is shocking that Lamborn would disregard the pleas of the supporting Veterans organizations, the silence of those groups in response to Lamborn’s offense is an even greater indictment of their often brazen Conservative posturing.

It is fortunate that America is not facing a Republican controlled US House.  With the likes of Lamborn in charge such a deserving and important piece of legislation could very well have been defeated.  Don’t hold your breath waiting for the national vets groups to thank the Democratic Congress, or criticize a Republican.

This is a clear example of the long-running self-destructive practices of the veterans and military advocacy groups.  Regardless of the truth and obvious merits of Democratic introduced policies and legislation it is all too often the reaction of the American Legion, Veterans of Foreign War and others to side with the Republicans who have inexplicably sided not with soldiers and veterans, but with off-shore defense contractors and mercenaries.

The past few months have provided a dizzying series of messages in the blogosphere praising or persecuting the new President of the United States (POTUS). Thankfully, Salon.com produced an “over the nation” report on the Republican Party today that deserves more attention, and a more in-depth analysis (from yours truly, naturally).

Here’s the Salon.com link - The state (by state) of the GOP

Once again, Dick Wadhams’ penchant for media attention provides the clue for how to defeat him and continue the GOP decline:

"This notion that Colorado has suddenly become a Democratic state is preposterous. I think Democrats who have a grip on reality know that." -- State GOP chairman Dick Wadhams

The lesson from Dick is a hard and true fact of politically strategy from today to 2012, and unfortunately, too many high level Democratic leaders are positively oblivious to the concept. While basking in the glory of Barack Obama’s victory, I am seeing too many messages ignoring recent losses and weaknesses going into future ballots. This kind of complacency and false posturing is a formula for a disaster in the 2010 General Election.

Salon.com is absolutely correct by highlighting the dominance of the GOP at the county and community level. Even in Larimer County, the Democratic Party leadership is mute on the loss of a seat on the Board of County Commissioners. Reveling in the glory of former Democratic Party Chair Betsy Markey defeating Marilyn Musgrave is apparently too intoxicating to take a clear look at the dangers of the political landscape.

HB 09-1273 - the Colorado Guaranteed Health Care Act - defines the structure for meaningful health care reform. It is the only current proposed systemic health care reform that addresses the crisis of health care financing and delivery. Read Bill Description & Summary.

It is popular to say that single, public-payer health insurance with full choice of providers is the solution, but it is "not politically feasible" - which has become an expression of the lack of political will to do the right thing. Fifty-nine percent of doctors (historically conservative) in a recent poll supported the single-payer model of health care reform.

A friend's doctor is one who no longer processes health insurance claims - he requires payment from his patients, whom he advises to file their own claims with their insurance companies. Similarly, some hospitals have been reported to require up-front payment from patients who have "catastrophic" insurances with high-out-of-pocket expenses (underinsurance), which notoriously result in unpaid medical bills. 

Thus far, HB 09-1273 has 15 House and 3 Senate cosponsors. Urge your legislators to sign on as cosponsor. HB 09-1273 could become a significant contributor to economic recovery.

The Following Groups have endorsed the the Colorado Guaranteed Health Care Act. If your group would like to endorse, contact info@healthcareforallcolorado.org.

• Colorado Nurses Association
• Colorado Medical Society
• National Association of Social Workers, Colorado Chapter
• Rocky Mountain Farmers Union
• Colorado Education Association
• League of Women Voters (Colorado)
• Junior League of Denver
• Colorado Cross Disability Coalition
• Autism Society of Colorado
• Colorado Social Legislation Committee
• Hunger for Justice Lutheran Advocacy Ministry of Colorado
• The Rocky Mountain Conference of The United Methodist Church
• Balanced Choice Health Care, Inc.
• Colorado Alliance for Retired Americans
• Be the Change USA
• Justice and Peace Ministry Team of the Rocky Mountain Conference of the United Church of Christ
• Arapahope Community Team
• LARASA (Latin American Research And Service Agency)

Attend the hearing for HR 1273 currently scheduled on March 18 at 1:30 pm in the Capitol Old Supreme Court Chambers, 2nd floor. 

Journalist T.R. Reid contrasts U.S. health care with that in 5 other industrialized nations in his documentary ‘Sick Around the World.’ None of the 5 countries he visited – Germany, Switzerland, Japan, Taiwan and Great Britain – utilizes for-profit insurance; all pay on average half as much per capita for health care as the U.S., and all have better health care outcomes, longer lives, etc.

Rather than a quality-centered health care system, the U.S. profit-centered model of health care has compromised our primary care infrastructure. At least one hundred overburdened U.S. emergency rooms have closed their doors over the past decade. It was recently reported that University Hospital became the 8th area facility to close its psychiatric unit; at the same time, it maintains a new 6-story building on the Fitzsimmons campus dedicated solely to billing, processing more than 1,000 different forms for over 1,000 different insurers.

Over 20 federal and state studies, including the Colorado Lewin Group study in 2007, have demonstrated billions of dollars of savings in health care spending, as well as the ability to provide comprehensive health care for all, utilizing a single-risk-pool publicly financed and privately delivered health care system.

The Colorado Guaranteed Health Care Act, HB09-1273, has been introduced to create the structure for comprehensive reform that guarantees health care for all Coloradans. In addition to streamlining administrative health costs, HB09-1273 stipulates annual negotiation of fair reimbursement to all providers; negotiation of prescription drug and medical equipment costs; support for education to address primary care, nursing and other provider shortages; and prioritization of retraining for displaced workers.

In the place of inadequate private insurances that have seen premium increases of more than 100% since 2000, the single public-payer model of health insurance separates health coverage from employment, establishes a sliding-scale premium based on income, and permits full choice of health care providers. Read more about the proposed bill at www.HealthCareforAllColorado.org, then urge your legislators to support HB09-1273, comprehensive health care for all Coloradans.

Following is a summary of the Colorado Guaranteed Health Care Act, setting up the framework for true universal health care in Colorado. It has been assigned to the House Business Affairs & Labor Committee, which meets on Tuesdays and Wednesdays (members listed below). Rep. Kefalas introduced HB09-1273 with fifteen House cosponsors (Representatives Gwen Green, Jerry Frangas, Lois Court, Randy Fischer, Dickey Lee Hullinghorst, Jeanne Labuda, Claire Levy, Joe Miklosi, Sal Pace, Edward Vigil, Dennis Apuan, Beth McCann, Anne McGihon, Su Ryden, and Sue Schafer). Senator Joyce Foster will introduce the bill in the Senate; presently, there are two cosponsors: Senators Morgan Carroll and Bob Bacon. Thank your legislators if they are cosponsoring the bill.

See Summary of Bill HB 09-1273 & Full 13-page Bill

John Geyman, M.D. (Do Not Resuscitate: Why the Health Insurance Industry is Dying, and How We Must Replace It) reports that administrative costs for the U.S. multi-payer health insurance bureaucracy is 5 to 9 times greater than that for not-for-profit traditional Medicare -- 20-26% vs. 3%; and that U.S. health insurance premiums have risen more than 100% since 2000, and are projected to consume all of household income by 2025. Furthermore, taxpayers are subsidizing private health insurance, e.g., privatized Medicare Advantage Plans, is 13% more costly than traditional Medicare.

A Harvard Study (7-9-02) reported that government's share of health expenditures nearly doubled since 1965, totaling almost 60% of total health costs in 1999. Government health costs include spending for Medicare, Medicaid, veterans and military, private insurance for public employees (members of Congress, firemen and school teachers, etc.), and tax-subsidized private coverage (e.g., tax credits for businesses’ coverage of employees).

T.R. Reid's documentary "Sick Around the World" draws a contrast between the higher cost and poorer outcomes of U.S. health care, with health care in 5 other capitalist countries. None of the 5 countries would tolerate conditions that result in medical bankruptcy (now 50% of U.S. personal bankruptcies). All of the 5 countries cover health care with some form of social insurance paid for on a sliding scale. None have for-profit insurances (except for certain supplemental policies). Following are 2 pages of notes made at the time Reid showed his documentary to state legislators and responded to follow-up questions.

"Sick Around the World," Documentary by Journalist T.R. Reid
Presented to a Joint Session of the Colorado House & Senate HHS Committees 1-8-09

For his documentary evaluating health care around the world, T.R. Reid visited 5 capitalist countries - Great Britain, Japan, Germany, Taiwan and Switzerland. He previously lived in Japan and Great Britain (x5 years), where he said his family received very good care from a doctor who lived on the block and made house calls.

The national insurance of most of these countries is covered by a sliding-scale tax or social insurance payment. None risk personal bankruptcy. The poor are subsidized. All countries spend roughly half as much on health care as the U.S. and have better outcomes. In all of the countries except Britain, medical education is free. Some profit for providers is accepted, however insurance profit for general medically necessary health care is not. Reid contrasts the five other capitalist countries with the U.S., with its "army of underwriters" practicing risk selection. In other countries claims are paid quickly, within 2 weeks. Great Britain has a public entity that makes decisions about coverage, e.g., cutoff for some procedures, such as kidney dialysis for the terminally ill. "They cover eveybody, not everything."

Reid reports that most capitalist countries don’t trust the unfettered free market and, thus, enact serious controls. He observes that universal care in the U.S. could begin at the state or federal level. If one state created a model, others would likely follow, as in Canada, where national health care started in one province (Saskatchewan, where insurers did not want to insure rural folks), covered by taxes. One by one, other provinces demanded the same.

Health care systems in all of the countries he visited share the following characteristics:

1) Insurance companies accept everyone (no exclusions) and do not profit from basic necessary coverage – even when coverage is accomplished through a number of private insurers. E.g., Germany has over 200 private insurers, who make an end-of-year financial report. To equalize risk among insurances, those that end the year in the black, share their income with those who end the year in the red.

2) There is a mandate for all to buy into the public social insurnace system, and government subsidizes the poor.

3) Doctors and hospitals negotiate annually for fixed-rate payment, whether they negotiate with a quasi-government or government entity, or with private insurers as a unit, as in Germany. There is no widening gap between numbers of primary care doctors and specialists (or their pay) as there is in the U.S.

4) Bankruptcy due to medical bills is unheard of in these countries.

5) Most utilize some form of IT, electronic medical records, and individual smart cards with medical history.

Great Britain excels at providing preventive health care. There is no health care billing to Britains. An example of true socialized medicine, providers work for the government, and are paid a fixed government salary, negotiated annually. General pracitioners are paid a bonus for keeping patients healthy. Britain has succeeded in reducing wait-lines for non-emergency procedures, e.g., hip replacement have been reduced from 18 months to 2-6 mos. Since 2008, Britains can choose among government hospitals. General practitioners act as gatekeepers to specialists.

The Japanese live the longest and have lowest infant mortality. Not-for-profit insurance in Japan is managed by employers, who pay half of the $250 family monthly health fee. Eighty percent of hospitals are private. Toyota has built hospitals for its employees in Japan. The Japanese Health Ministry negotiates a standard fixed price for doctor fees, drugs, etc. Because Japanese costs are so low (e.g., cost is $10/night for a hospital room for 4), 50% of hospitals are in financial deficit, demonstrating the need to raise rates. Japanese spend 8% GDP on health, half as much as the U.S. Reid notes that U.S. health costs are much higher due to the hodge-podge of many different systems for everyone. Most countries have the same care at the same price for all.

Germany has had the Bismarck model of comprehensive health care since late 19th century. Ninety percent remain in the system; about 10% of the rich opt out and pay private coverage. Germany eliminated its former profit-based insurance. Now income-based premiums are paid to 1 of 240 private not-for-profit insurers. There is a $15 copay every 3 months, with pregnant women exempted. Insurance management gets better pay for serving more customers. Doctors (with free medical education) earn half of U.S. doctors’ pay, and work long days (family doctors make $120,000/yr. – 2/3 of U.S. doctors’ income). Reimbursement is negotiated annually by the German states. To equalize insurers’ risk, insurers that end the year in the black, share their income with companies in the red.

Taiwan designed a new health care system in 1995 after looking at 15 other countries, discounting the U.S. health care model as a "market-not-a-system." They created a national insurance with no opt out, no gatekeepers and no wait lines. Information technology plus smart card with each person’s medical history facilitate health care. Taiwan has the least administrative costs of all countries (2%), as providers bill the government directly. Taiwan’s health costs are less even than Japan’s (6.3% GDP). They have the leeway to increase premiums, but because they are so reluctant to do so, the government must borrow to pay providers.

The Swiss passed a referendum by slightly more than 50% to create national health care in 1994. In Switzerland, insurance is mandated and not-for-profit. Strong incentives keep administrative costs at 5% (vs. 22% in U.S.). Insurances may offer supplemental care for profit. Premiums are $750/mo for family (2nd most expensive after U.S.). The Swiss see limits to a pure free-market, and view health care as a value. The conservative Swiss President calls health care "a right," and says it would be a "scandal" for the Swiss to experience medical bankruptcy, as many do in the U.S.

Reid notes that for most of its history, until the 1980s, U.S. health insurance was not-for-profit. Since then, insurance administrative costs have ballooned. Consequently, he notes, the new Colorado Health Sciences Center has a 6-story building dedicated solely to billing, handling 1600-1700 different forms. U.S. insurances are not transparent. The for-profit insurance industry overhead costs are 18-24% of health care dollars. Other countries present one bill for surgery, whereas a single U.S. procedure can come with 30 different bills. When asked what might happen to insurance middlemen in a reformed system, Reid replied that there would be plenty of health care jobs for which to retrain them.

Reid’s next documentary, due in April, will examine what happens to Americans who think they are insured, but because they carry high deductibles of $2,000-10,000, cannot access their insurance, and cannot pay for health care.

View "Sick Around the World" and related interviews

The dialogue around health care reform has been stifled and distorted by those who profit from the current system, so I wanted to share with you a piece I wrote for the Huffington Post -- Corporate Profit Continues to Define Health Care Reform & the U.S. Race to the Bottom. Please comment on the piece, if you like. I think that employers should certainly contribute to health care based on numbers of employees, but health care should not be tied to employment. 

T.R. Reid, PBS journalist who made the documentary, Sick Around the World, is scheduled to show his documentary & comment to a joint session of the Senate-House Health & Human Services Committees this Thursday, Jan. 8 at 1:30pm- 3:30pm at the Legislative Services Building (across from the Capitol at 14th St. on Sherman) in Hearing Room A. The documentary has been shown a number of times on PBS Frontline. Reid lived in other countries, including England, where he found health care to be much more accessible and affordable than in the US.

For several years now the evidence of the Alberto Gonzales gang's manipulation of the Federal Civil Service within the Department of Justice has been well publicized. The fact that right-wing political ideologues were being approved for career professional positions based on social issue orthodoxy, rather than competence and qualifications, is yet another blight on the scandalous legacy of the current occupant of the White House.

Today's report in the Washington Post reveals that this practice of burrowing right-wing political operatives into the Civil Service is also in-place in the scientific agencies. Perhaps this is the mis-administration's strategy for making permanent the Republican obsession for combating the truth of science with their twisted political and social priorities.

The Center for Public Integrity is soon to release their "Broken Government" study. The fund-raising teaser release promises 120 specific cases. This kind of investigative effort to hold the Bushies accountable as the mis-administration fades into oblivion is crucial.  Revealing and acting on the depth and breadth of this conspiracy is vital to the success of any reforms and corrects to the offenses of the past eight years.

The Obama-Biden Administration will be stretched and tested to uncover and flush-out these right-wing activists who have burrowed their way into the Civil Service like so many termites. The evidence of these infestations must be met with quick action.

Executive appointees selected for positions above these people must be prepared to take every possible action within the laws and regulations of the Civil Service structure to either get them dismissed, or make it too hard for them to stay and accomplish their nefarious goals. Attention to the selection of the Administrator of the Office of Personnel Management will be a key to success in this area.

Various Executive agency inspectors general must be supported in investigating these political opportunists. IF they are found to be substantially unqualified for the job description that they were hired to fill, then it should be clear grounds for dismissal as an unlawful appointment.

The Obama-Biden appointees who are saddled with these burdens must enforce clear, precise and enforceable performance standards. When confronted with qualitative requirements to enforce and perform based upon laws and regulations that these infiltrators are likely to hold ambitions to undermine and avoid, could more easily force them to resign.

Even in its demise the minions of the current mis-administration are appearing to be increasingly unwilling to follow the current occupant of the White House and the vice out of Washington. This certainly adds to the challenge and urgency of establishing the new administration's executive leadership. Too many months and too many acting, caretaker, leaders in the executive departments will make it all the harder to untangle the tentacles of the Bush parasites.

Failed U.S. health care is a major contributor to our systemic economic crisis. Indeed, the excesses of Wall St. and the subprime mortgage catastrophe mirror U.S. health care policy – both are typified by privatized profit (for investors and insurers), and socialized risk (for taxpayers and consumers). Inflated U.S. health care costs – 16% of GDP and rising – are major contributors to an inflationary economy. Redress of this single aspect of an out-of-control U.S. economy would lift all boats. Comprehensive health care reform would improve the economic status of all, relieving health access concerns of families, individuals and businesses, large and small.

So-called "legacy costs" alone, comprised largely of retiree health and pension benefits, have contributed significantly to General Motor’s negative cash flow, prompting yet another request for government bailout. In 2005, costs of health care coverage to GM amounted to $5.6 billion for 1.1 million employees, retirees and their dependents. In 2005 BusinessWeek reported that legacy costs added $1,600 to the cost of each GM vehicle.

It’s time to confront the crippling economic effects of employment-linked health coverage that reduces competitiveness of businesses in the world marketplace, reduces effective employee take-home pay, and adds to the costs paid by all for goods and services (note above cost added to each U.S. -made car). State and city budgets, too, are depleted by escalating health costs for employees and retirees.

Progressives leaders must do a better job of promoting civic discourse while clearly defining issues, like health care reform. Democrats shoud cease parroting right-wing framing and code words intended to distort the issue, e.g., "government health care" or "socialized medicine," as a couple of recent Colorado candidates have done. We need to refute Republican "free-market" advocacy that treats health care as a commodity to be exploited for maximum profit, with top-skimming of over 25% of health care dollars for private insurance shareholder profits, CEO salaries, excessive administrative costs, marketing, lobbying, etc. "Free-market" health care is as perverse an incentive as free-market police and fire protection would be, leaving everyone vulnerable, at the mercy of the marketplace.

Barack Obama showed promise broaching issues during the campaign. He made a start at explaining the high cost of privatizing Medicare (13% higher than traditional Medicare), and the failure of Medicare prescription drug reform that prohibits negotiation of bulk drug rates, as the VA does to save money. The 2003 reform was a giveaway to insurance and pharmaceutical lobbies, with billions of dollars of taxpayer subsidies and inflated costs to benefit their bottom lines. Now is the time to make the case for an improved Medicare for All - a public insurance with true free choice of providers and hospitals. By contrast, for-profit insurance choices are narrowly limited to "in-plan" providers, necessitating change of providers with change of insurance.

Comprehensive health care reform shoud be part of a broad economic remedy. U.S. health costs are almost double those of all other industrialized nations, and growing; yet we still experience worse overall health outcomes. Increasing numbers of underinsured pay escalating costs for decreasing coverage. Taxpayers currently pay for over 60% of health care costs, including 70% of legislators’ health coverage. By many accounts, that is enough to provide single-risk-pool coverage for all.

In fact, single-payer health care is the only model of reform that has demonstrated in over 20 federal and state studies the capacity to save money and provide comprehensive coverage for all.

It is time for reform that benefits the worker as well as the CEO.

First posted on Huffington Post 11-13-08

The "right-to-life" movement that elevates embryonic life above women's lives is more accurately termed "right-to-prenatal-life." One of the most extreme 2008 anti-abortion, anti-contraceptive ballot measures is the so-called Colorado "Personhood" amendment - number 48 - defining fertilized eggs as "persons" with Fourteenth Amendment rights to "life, liberty and due process of law." Simultaneously, rightists have opposed the same rights for women as "reading feminism into the Constitution."

Both Amendment 48 and a rule change proposed by the Bush administration Department of Health and Human Services would re-define pregnancy as the point of conception, disregarding the medical definition of pregnancy - "the implantation of a fertilized egg." They would effectively categorize as abortion any contraception (e.g., the pill, IUD, emergency contraception, contraceptive patch) that interferes with the implantation of a fertilized egg, thus outlawing most contraception - the primary means to reduce the need for abortion.

In a slippery slope to 19th century status for women, rightists have promoted "conscience clauses" permitting pharmacists' and others' refusal to fill prescriptions or provide health care for women. The HHS proposal states, "[T]he conscience of the individual or institution should be paramount in determining what constitutes abortion..." - holding women's health hostage to anyone's professed religious/ideological beliefs.

It is time to recognize that abortion serves as surrogate for a spectrum of unspoken issues related to female personhood and male entitlement. The anti-abortion political litmus test was introduced by Paul Weyrich, who dictated that women step aside and "make way for new life." It serves dual purposes - the marginalization of women and the lightning rod around which to mobilize political coalitions, notably, Evangelicals and Catholics. The elevation of fetal life over women's lives, coupled with conservative strategist Howard Phillips' euphemistically described goal of return to "one-family-one-vote," is calculated to marginalize and disenfranchise women, consistent with the ultraright tenet that ultimately, only select white Christian males should retain the right to vote or hold office.

Rickie Solinger concluded from her historical research of women's health care that women's rights have often been held hostage by politicians and others with "political agendas hostile to female autonomy and racial equality" (Wake Up Little Susie: Single Pregnancy and Race Before Roe v. Wade, 1992). The criminalization of contraception and abortion, and the widespread U.S. adoption black market that assigned value to babies and punishment to women based on race, were some effects of pre-Roe efforts to control women's reproduction.

At core, Weyrich's anti-abortion, anti-contraceptive and abstinence-only ideology serves as cornerstone of an anticipated male supremacist theocracy. It is the platform upon which the majority of Republican candidates continue to run in 2008. The greatest conceit - that pregnancy is not a health issue and women's lives are expendable - underlies the dual standards of Republican Party pronatalist policy demanding female submission to males who presume the right to hold women hostage to personal beliefs.